Founder
Dr. Roland Segal is a leading psychiatrist with extensive experience and is the Managing Partner and MD Psychiatrist at Legacy Recovery Center. After earning his medical degree from the University of Arizona, College of Medicine, he completed general psychiatry training at Banner Good Samaritan Medical Center in Phoenix, Arizona, and advanced his expertise through a forensic psychiatry fellowship at USC’s Keck School of Medicine.
With over a decade of diverse experience in clinical, administrative, and forensic psychiatry, Dr. Segal is double board-certified in General and Forensic Psychiatry. His previous roles include Chief Medical Officer at Valley Hospital in Phoenix, Arizona, and president of the Arizona Psychiatric Society. He has also served as the legislative committee chair and contributed to numerous state and national boards, committees, and organizations. Additionally, Dr. Segal teaches as a clinical assistant professor of psychiatry at the University of Arizona, College of Medicine, mentoring medical students and residents.
Dr. Segal acts as an expert psychiatry consultant for multiple superior and regional courts, including those in Maricopa and Yuma counties, Salt River, as well as city governments like Phoenix, Lake Havasu, and Mesa. He also consults for prominent organizations such as the United States Postal Service, Social Security Administration, Immigration Health Services, and the U.S. Departments of Justice and Homeland Security.
Guided by principles of objectivity, ethics, mindfulness, and cultural awareness, Dr. Segal remains dedicated to providing compassionate, inclusive psychiatric care, impacting lives across Arizona and beyond.
While often used interchangeably, it can be confusing to know the difference between Post-Traumatic Stress (PTS) and Post-Traumatic Stress Disorder (PTSD). PTSD is often used to describe any traumatic stress. But PTS is a term that is gaining traction. It is also called Acute Stress Disorder (ASD) by clinicians. While initially they share some symptoms, they represent distinct points on a spectrum of trauma response.
The difference has to do with timing and intensity. PTS is a common, often temporary response, and PTSD is a diagnosable mental health condition. Recognizing the difference is important for destigmatizing normal reactions, identifying when clinical intervention is needed, and fostering effective paths to recovery. In this article, I explain the differences.
What is Post-Traumatic Stress (PTS)?
PTS describes a normal, natural, and often temporary set of stress reactions following a traumatic event (e.g., accident, assault, natural disaster, sudden loss). It’s the mind and body’s emergency protocol staying “online” after the danger has passed.
PTS describes normal, time-limited reactions such as feeling on edge, having nightmares, or avoiding reminders in the days to weeks after trauma; it is not a formal DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnosis. Many people experience PTS symptoms that gradually resolve as the nervous system recalibrates [1].
Common Symptoms
Symptoms present as four clusters, which are mild or sub-clinical.
- Re-experiencing: Intrusive thoughts, nightmares, or flashbacks.
- Avoidance: Steering clear of reminders of the event.
- Negative Alterations in Mood: Feeling numb, detached, or guilty.
- Arousal and Reactivity: Being jumpy, having trouble sleeping, or feeling irritable.
These symptoms typically last from a few days to one month. While distressing, they do not severely impair one’s ability to function in work, relationships, or daily life.
Research suggests that most people with PTS, also known as Post Traumatic Stress Symptoms (PTSS), may have mild or moderate symptoms. Only some report severe symptoms. In a 2023 study, 20% of trauma survivors with PTS reported severe symptoms. Additionally, 40% had moderate symptoms, 30% had mild symptoms, and 10% reported minimal symptoms [1].
What is Post-Traumatic Stress Disorder (PTSD)?
PTSD is a clinically diagnosed mental health disorder recognized in the DSM-5. It occurs when the symptoms of acute stress persist, intensify, and cause significant functional impairment beyond one month. It involves specific symptom clusters (intrusion, avoidance, negative mood/cognition changes, and arousal changes) persisting beyond one month after trauma.
PTSD represents a change in the brain’s fear circuitry and stress response system getting “stuck.” PTSD is associated with significant distress or impairment in social, occupational, or other important areas of functioning [1].
Diagnostic Criteria Highlights
- Duration: Symptoms last for more than one month.
- Severity: Symptoms are more pronounced and specific (e.g., distinct avoidance of both thoughts and external reminders, persistent distorted blame, a pervasive negative emotional state).
- Functional Impairment: Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (e.g., unable to work, maintain relationships, leave the house).
- Key Characteristic: It’s a chronic condition that often requires professional treatment to heal
The Core Differences
Anxiety, feeling jumpy or on edge, nightmares, avoidance of reminders, and intrusive thoughts about the event are all shared features. People sometimes confuse PTS and PTSD because of these overlaps.
The main differences are as follows [2] [3]:
1. Nature and Classification
- PTS: This is a normal stress response and is not a mental health diagnosis.
- PTSD: This is a clinical mental health disorder with formal diagnostic criteria.
2. Duration
- PTS: Temporary. PTS symptoms typically show soon after the event. They improve within days to a few weeks, often resolving within about a month.
- PTSD: Persistent. PTSD symptoms last beyond one month and can be chronic without treatment. They may continue for months or years if untreated.
3. Severity and Impact
- PTS: Symptoms are manageable. They do not cause major functional impairment. Initial reactions can be intense but usually diminish and do not continue to disrupt daily life.
- PTSD: Symptoms are debilitating. They can cause significant impairment in daily life. They often include ongoing re-experiencing, strong avoidance, negative beliefs, and hyperarousal. They substantially interfere with work, relationships, and overall functioning.
Why the Distinction Matters
There are several reasons why it’s important to understand the difference between PTS and PTSD:
Destigmatizing Normal Reactions
Labeling common PTS as “PTSD” can mislabel a natural human response.
Guiding Appropriate Intervention
For PTS, support, self-care, psychoeducation, and time are often sufficient.
For PTSD, trauma-focused therapies like Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy (CPT), or Prolonged Exposure Therapy (PE), and sometimes medication, are typically essential for recovery.
Encouraging Seeking Help
Understanding the timeline (e.g., symptoms persisting past a month) provides a clear indicator for when to seek professional help. It turns a vague feeling of “not getting better” into a sign it’s time to get help.
Get Expert Help at Legacy Recovery Center
Legacy Recovery Center is a highly rated, premier addiction and mental health treatment center in Arizona. Legacy is owned and operated by two psychiatrists with over 40 years of combined experience, as well as a robust therapeutic team.
We’re unique among residential treatment centers thanks to our ability to help people suffering from mental health and/or substance abuse issues. Our expert psychiatric team is equipped to treat multiple issues concurrently, focusing on your specific needs.
Sources
[1] Shih, C., et al. (2023). Early self-reported post-traumatic stress symptoms after trauma exposure and associations with diagnosis of post-traumatic stress disorder at 3 months: latent profile analysis. BJPsych open, 9(1)
[2] Shalev A. Y. (2009). Posttraumatic stress disorder and stress-related disorders. The Psychiatric clinics of North America, 32(3), 687–704.
[3] Villines Z. 2024. PTSS vs. PTSD: What are the differences? MedicalNewsToday.
